Buggy

By Peter Galvin, MD

Bedbugs are insects that feed on human or animal blood, and their bites can cause skin reactions. They thrive in warm, dark environments and often live in mattresses, furniture, flooring, and walls, commonly in hotels, motels, hostels, shelters, and other high-occupancy places. They are active at night and are attracted to their hosts based on body temperature and exhaled carbon dioxide. Bedbug bites cause multiple itchy, red bumps on exposed areas of the body such as the head, neck, arms, and legs. The bumps can have a dark red bite mark in the center and may be arranged in a group or line, sometimes called the “breakfast, lunch, and dinner” sign. Some bites can cause blisters, likely related to proteins released in bedbug saliva during feeding. Although bedbugs do not spread infectious diseases, their bites can cause anemia, sleep disturbances, and psychological distress, including anxiety and depression.

Bedbug infestation can be diagnosed based on history, skin findings, and environmental inspection. Bedbugs are nocturnal, so close inspection of sleeping quarters, furniture, or holes in flooring and walls at night can help detect these insects. Pest management experts may perform visual inspection or use dogs trained to identify bedbug scents. In addition, infestation can be identified with passive monitors, which are small mechanical traps, or active monitors, which are small devices that lure bedbugs with heat or carbon dioxide.

Skin reaction to bedbug bites typically resolves in about one week without treatment. Topical steroids are often helpful to control symptoms of itching, although individuals with severe itching may require or medications such as antihistamines or gabapentin-like medications. Skin infections that result from scratching may be treated with topical or oral antibiotics. Because eradicating bedbugs from the environment can be challenging, pest management professionals are best equipped to manage infestations. They may employ extreme heat-exposure to temperatures of 113 to 118 degrees for one hour which kills all stages of the bedbug life cycle – or freezing temperatures to infested items or entire rooms as well as laundering, vacuuming, and insecticide use. Pest management professionals may need to use combinations of insecticides because in some areas bedbugs have become resistant to certain insecticides.

Complete eradication of bedbugs may require repeated pest management visits, driving the cost of eradication to high levels, for example at least $1225 for a single-family home. Twenty-one states currently have laws declaring that landlords and hotels are responsible for bedbug eradication. To decrease the risk of bedbug infestation, individuals should carefully inspect new living arrangements, hotel rooms, and luggage when they move or travel. Used furniture should be isolated and thoroughly examined before use. In many US cities, landlords must disclose prior bedbug infestations to prospective tenants. For more information go to the website of the American Academy of Dermatology at www.aad.org

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